Cost of Cancer Drugs

Roche Not Embarassed

2006-09-30T10:11:00.000-07:00

Source: Reuters
Thomas Atkins, 20 June 2006

Swiss drug firm Roche is not embarrassed by the high cost of some of its breakthrough cancer drugs and even has room to raise prices in the United States, a senior executive said on Tuesday. Roche has produced enormous advances in cancer treatments in recent years with drugs like breast cancer treatment Herceptin and tumour-buster Avastin.

But the drugs' high prices – running to tens of thousands of dollars a year – have sparked a lively debate about whether their developers have gone too far and risk a backlash.

"We have looked at the cost and the benefit and then gone to the hospitals to see if we could pass the red-face test," said Roche pharmaceuticals head William Burns at a media event. "We have no difficulty looking people in the eye and asking for it."

Development work for some of the drugs, like Avastin, took scientists 30 years to complete. "There was no guarantee we could crack it," Burns said. "We still, at the end of the day, have to give a return to our shareholders who took the risk."

Cancer is the fastest-growing section of the pharmaceuticals market, reflecting the growing incidence of the disease and the development of costly targeted therapies that extend lives with far fewer toxic side effects than standard chemotherapy.

A number of rival companies including industry giants Pfizer Inc. and GlaxoSmithKline Plc are now moving into the sector in force.

Roche's sales of cancer medicines totalled 10.2 billion Swiss francs ($8.3 billion) last year from 1.6 billion in 2000, fuelled by blockbusters like MabThera, Herceptin and Avastin. "If you have demonstrated the benefits, in the U.S. you can still raise the prices”.

Cancer Drugs top US$100,000 a year

2006-09-30T09:57:00.000-07:00

Cancer drugs can top $100,000 a year but None Cures Cancer
Source: Chicago Sun-Times
Jim Ritter, 27 March 2006

A new generation of high-tech cancer drugs is extending patients' lives, but the costs are stunning.

Take Erbitux, approved for advanced colorectal and head-and-neck cancers. It costs $327 a day, $9,800 a month, $118,000 a year. And that doesn't count the cost of administering the intravenous drug.
New drugs for non-Hodgkin's lymphoma and for lung, breast, pancreatic, kidney and stomach cancers also cost thousands of dollars a month.
Drug companies are seeking to expand the lucrative market by testing the drugs on other cancers. They also are developing new drugs.
"Some of these agents are outrageously expensive," said Loyola University Health System oncologist Dr. Patrick Stiff.
Drug companies make no apologies. They say their new drugs are much more expensive to make than traditional chemo drugs. Companies say they need to recoup the hundreds of millions of dollars it can take to bring a new drug to market. It's a risky business.
For example, Onyx Pharmaceuticals has been in business 14 years and raised $700 million from investors. But so far, Onyx has brought only one drug, Nexavar, to market. Nexavar, for advanced kidney cancer, costs $4,333 a month.
None of the new drugs cure cancer, and for many patients, they don't help at all.
But for some patients who have advanced cancers that have not responded to other treatments, the drugs halt or shrink tumors for weeks or months. And the side effects often are less toxic than standard chemotherapy.
Patients typically take the new drugs until the cancer progresses. For example, patients with advanced colorectal cancer took Avastin ($4,400 a month) an average of 10 months in a clinical trial. The median survival was 20 months, compared with 15 months for chemotherapy alone.
Industry critics concede that cancer drugs are expensive to develop. But they also give another reason for the astronomical prices: the industry-friendly health care system in the United States. Congress has prohibited Medicare from even negotiating prices with drug companies. So with patents protecting new drugs from generic competition, drug companies "can charge whatever they want," said University of Chicago oncologist Dr. Mark Ratain.

Unsustainable Cost of Cancer Drugs

2006-09-30T09:51:00.000-07:00

Source: Cancer's Cost Crisis
Matthew Herper, Forbes. 8 June 2004

After helping to develop some of the hottest new biotech drugs, Memorial Sloan-Kettering cancer doctor Leonard Saltz has come down with a bad case of sticker shock. The price tag for treating patients has increased 500-fold in the last decade.

Ten years ago, doctors could extend the life of a patient who had failed to respond to chemotherapy several times by an average 11.5 months using a combination of drugs that cost $500 in today's dollars. Now, new medicines such as Avastin and Eloxatin can extend survival to 22.5 months, but at a total cost of $250,000. And that doesn't include pharmacy markups, salaries for doctors and nurses, and the cost of infusing the drugs into patients in the hospital. That kind of cost is unsustainable.

Costly Drugs Force Life, Death Decisions

2006-09-30T09:45:00.000-07:00

Source: CBS News, 12 August 2006

More patients are confronting this wrenching decision, as the latest generation of pricier cancer drugs … stretches out the final months of advanced disease. Is the chance for several more months of life – maybe a year or more with luck – precious enough to spend a small fortune?

Within the last decade, an array of expensive new treatments has given some patients their first real fighting chance against common diseases once routinely called "terminal." The trouble with many treatments, though, is that average patients gain only several more months of life, studies have found. A lucky few may survive for years, so many seek treatment in the hope of beating the odds.

Faced with such a disease, more than a third of Americans now would want "everything possible" done to save their lives. For many on the brink of death, the choice of desperate measures is hardly a choice at all. "It's better to pay the money than sleeping with the worms," said Jake Rogers, 62, of Chicago.

Take also the example of the new biotech drug Avastin, which treats colon cancer for about $4,400 a month. Effectiveness? It is proven to extend average life by up to five months. In a survey this year, only one-fourth of 139 cancer doctors felt that represents "good value."

Genentech, which makes Avastin, believes its drug prices provide reasonable value to patients.

Cost of Survival

2006-09-30T09:35:00.000-07:00

Cost of Survival: New cancer drugs can extend life,
but come at a high price
Source: journalnow.com

When you're being robbed at gunpoint, the question often asked is, "Your money or your life?" Increasingly, that is the choice cancer patients are being offered.

The cost for many new cancer drugs is almost unbelievable. Herceptin, a drug for breast-cancer patients, costs $3,200 a month.

Avastin, for colorectal cancer, can cost $4,400 a month.
Rituxan, for nonHodgkin's lymphoma, runs $13,000 to $25,000 for one cycle of treatment.
Revlimid, a newly approved treatment for multiple myeloma, could cost up to $60,000 a year.
And Erbitux, for head and neck cancer or colorectal cancer, might exceed $110,000 a year.

Even for people with insurance, these bills are traumatic. Anyone without insurance is out of luck

A revolutionary medicine such as Avastin that is approved by the Food and Drug Administration for colon cancer may not yet have official approval against ovarian cancer, even though oncologists are prescribing it for this malignancy.

What's behind the enormous cost of cancer medicine? Twenty years ago, we spoke with a drug-company insider. This former executive related a top-level meeting in which the question was raised, "If you found a cure for cancer, what would you charge for it?" The executive who was being grilled admitted that they would almost have to give it away. At that time, pharmaceutical leaders feared they would be seen as unethical if they gouged patients for life-saving medicine.

Those restraints have disappeared. These days, cancer therapies have become the holy grail for profitability. Many new high-tech compounds don't cure people, but they do extend lives. The drugs are more effective and often better tolerated than old-fashioned chemotherapy.

Drug companies often justify high prices by pointing to the expense of conducting research. No one doubts that developing anti-cancer compounds is expensive. But when a year's treatment tops $100,000 a patient, the industry risks pricing itself out of the market for lifesaving drugs.

Attack on Cancer Drug Costs

2006-09-30T09:25:00.000-07:00

CBS, ABC Attack Companies on Cancer Drug Costs
Source: Business & Media Institute. 12 July 2006
Ken Shepherd

ABC and CBS evening newscasts attacked the pharmaceutical industry for expensive drugs for cancer treatment. CBS even criticized the industry for “only” saving patients for up to another year.

In the last year, the cost of cancer drugs climbed 15 percent compared to 3.3 percent for other drugs, CBS’s Trish Regan complained. Regan lamented that “drug companies are reaping the benefits” in strong profits.

According to the Pharmaceutical Research and Manufacturers of America, the average cost of developing one new prescription drug costs $800-million in research over 10-15 years while only three out of every 10 marketed drugs end up breaking even or turning a profit.

“Some of the most expensive drugs may only extend the patient’s life a few months or a year,” CBS’s Regan noted during her story as she introduced a cancer specialist. “That’s really, I think, the crux of the problem. That for a modest improvement, there’s a huge increase in cost,” Dr. Leonard Saltz of the Memorial Sloan-Kettering Cancer Center told Regan.

Cancer Drugs for Fortunate Few

2006-09-30T09:12:00.000-07:00

Cancer drugs priced for the fortunate few
High cost of new medications burdens patients
Source: Robert Bazell, NBC News. 14 March 2006.

They are the cancer drugs doctors and patients have sought for years. They target and kill cancer cells — often with fewer side effects than traditional chemotherapy — but they come with a huge price tag.

The costs have skyrocketed so high. Examples of the annual cost for some drugs:

Tarceva for lung cancer: $35,000

Herceptin for breast cancer: $38,000

Avastin for colon cancer: $54,000

Erbitux for colon cancer: $110,000

Why are the prices of cancer drugs so high? Drug companies refuse to talk about how they set prices, and under the law, they can charge whatever they want.

Indeed, experts say the new cancer drugs are becoming one of the biggest strains on the entire health care system.

Comments from Cancer Answers: These drugs have been hyped and touted as "the miracle drugs" and then sold at exhorbitant prices. Yet, there are so many articles and news about how these drugs have failed to live up it their claims. From a lighter side, perhaps it is better to keep the drugs at a cost not affordable to the masses so that less cancer patients suffer from their severe side effects.

Selling Hope or Selling Drugs That Don't Cure

2006-09-30T08:01:00.000-07:00

Source: NEW YORK TIMES 12 July, 2005
by Alex Berenson

Comments from: Mindfully.org
Be sure to understand that hope is what they are selling and not cures. Extremely high costs for the patient and extremely high profits for the corporation are the norm, as well as no cure.

The usual corporate pharmaceutical claim is the amount of time and expense it takes to create such drugs is enormous and must be passed on to the patient.

Then they must get the drugs approved by, what they claim is, the toughest and most costly approval process on earth, which may be true. But that regulatory agency — the FDA — is also one of the least effective agencies at protecting the US citizen from these drugs.

The FDA is wrought with internal problems and is heavily influenced by the regulated industries themselves. The revolving door of employment between industry and the FDA moves so quickly that it is no longer visible to the human eye.

Not Cure, But At a High Expense

2006-09-30T04:21:00.000-07:00

Cancer Drug Offer Hope, Not Cure BUT at a Huge Expense

Source: NEW YORK TIMES 2 July 2005
Alex Berenson

Avastin. Erbitux. Gleevec. Herceptin. Rituxan. Tarceva. These are among the first in a wave of new drugs giving hope to millions of cancer patients by treating the disease in new ways, like blocking the blood vessels that feed tumors.But they are all highly expensive, up to $100,000 for a course of treatment that lasts a few months.

A year's supply of the drug for an average colon cancer patient costs $54,000.
Tarceva for lung cancer costs almost $90 a day, or $31,000 a year
A drug called Thalomid for treating multiple myeloma costs $25,000 year

That is hundreds of times the cost of older, more toxic cancer drugs. The new cancer drugs help most patients only marginally, prolonging life by a few weeks or months.

Drug companies say many factors drive the pricing of their drugs, including the high cost of research and development, complex and expensive manufacturing processes and the value the drugs provide for patients.

Cancer is a uniquely frightening disease, and people will pay almost any price for treatments. Also, most cancer drugs do not have good substitutes; if a drug works - even marginally - patients and doctors clamor for it.

While some of the new drugs are difficult to make, their prices are unrelated to their manufacturing costs. Drug makers charge what they think the market will accept. It's sort of one of those things where everyone looks over their shoulder at everyone else, says, 'He started it, it wasn't me,' and it builds.

The upward spiral started in 1992, when Bristol-Myers Squibb began charging $4,000 a year for Taxol, a breast cancer treatment that was among the first so-called targeted drugs, which are aimed at destroying tumors without the side effects of traditional chemotherapy. At the time, some lawmakers and patient advocates complained, noting that Taxol had been invented at taxpayer expense at the National Cancer Institute. But Bristol held firm.

Then in 1998, Genentech began charging $20,000 a year for Herceptin, another targeted therapy for breast cancer. The price attracted notice, but little criticism.

Four years later, Bristol and ImClone Systems began charging as much as $100,000 a year for Erbitux, a drug for advanced colon cancer. (Because different patients have different treatment cycles, these prices are averages, as computed by the companies or financial analysts.)

For drug makers, the high prices have been a boon. Cancer drugs will be the fastest-growing part of the drug market for the next five years. Every major drug maker is now investing heavily in oncology.

Dr. Richard A. Deyo, a professor at the University of Washington and co-author of "Hope or Hype: The Obsession With Medical Advances and the High Cost of False Promises," said that most patients overestimate the value of the new drugs. "We're talking about adding a few weeks or months of life for people who are very sick," Dr. Deyo said.

Experts Question High Cost of Drugs

2006-09-30T00:43:00.000-07:00

Source: HealthCentral.com

Cancer treatments are the most expensive medical therapies in the United States, and a panel of experts said it is time to rethink the cost of drugs that only add a few months to a patient's life.

Convening at the American Society of Clinical Oncology annual meeting in Atlanta this weekend, the six doctors on the panel noted that physicians and ethicists alike are struggling with the dilemma.

The cancer treatment industry is a $210 billion annual enterprise. A steady stream of highly priced drugs has been pumped out by the pharmaceutical industry in recent years, and these medications tend to cost insurers and patients $2,000 to $5,000 a month, the panel said. However, these treatments have captured both headlines and the attention of patients desperate for a few more months of life.

Subsidising High-cost Drugs

2006-09-30T00:20:00.000-07:00

Subsidising high-cost drugs a mater of life, not death
Source: The Age,

Australia

. 23 April 2006.

Herceptin for breast cancer, Avastin for bowel cancer and Tarceva for lung cancer. They are extending, if not yet saving, lives, but at vast expense.

A course of Herceptin, for example, costs about (Australian) $66,000 a year.

"Do oncologists discuss expensive anti-cancer drugs with their patients?" One third of the doctors responding to the survey said that if the drugs were not subsidised, they would not mention them to their patients. Main reasons: discussion would "worry the patient", or the doctor would "feel bad" mentioning a drug the patient could not afford… some doctors feel concerned enough to withhold information for reasons of cost says that something is wrong with a system that imposes such costs.

So what could be done to make high-cost drugs such as Herceptin available to all those who need it rather than purely to those who can afford it?

High Cost of Cancer Drugs

2006-09-30T00:11:00.000-07:00

Source: Sarah White, 11 July, 2006
On Healthy Living

USA Today reported the cost of cancer drugs has skyrocketed, even compared to the rising cost of other types of drugs. The cost of cancer drugs rose 16 percent last year, compared to a 3 percent rise for other kinds of prescription drugs. The newer drug therapies tend to be the most expensive, with some costing around $10,000 a month.

The drugs available in 1996 to treat advanced colorectal cancer cost $500 and … the current drugs cost $250,000. Drug companies say they have to make profits, and they aren’t out to take advantage of patients with life-threatening illnesses.

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Source: Reuters, 4 May 2006

For investors, cancer medicine has been a hot ticket to profit in the past two years, and more promising updates on new drugs are expected. Cancer has become a magnet for pharmaceutical research dollars and competition in the field is growing fast. Pharmaceutical information specialist IMS Health estimates there were a total of 96 cancer products in final Phase III clinical trials or awaiting approval at the end of 2005, nearly double the 51 being assessed for heart disease.

US$800 Million Dollar Pill

2006-09-29T23:08:00.000-07:00

High cost of drugs has little to do with innovation

The drug industry staunchly defends high prices as essential to fund critical drug research and development.

How valid is the drug industry's claim that high profits are necessary to support medical progress? In his new book, The $800 Million Dollar Pill, Merrill Goozner sets out to provide some answers. The title refers to what drug manufacturers claim it costs them to get a new drug approved by the FDA – an estimate that is considerably exaggerated.

Goozner asserts that drug prices aren't based on the actual cost to invent them. He reports that the National Institutes of Health has absorbed much of that cost by playing a key role in developing virtually every new drug created in the past 2 decades.

Goozner argued that the private drug industry investment has not been the most important factor in the discovery and development of important new therapies. The success of the drug industry in developing new, life-saving treatments has been largely dependent on government sponsored research and researchers. The result is that American taxpayers end up paying twice: first through their tax dollar support of the National Institutes of Health and of academic research – and then again by paying high prices when they need the drugs.

The author profiles companies such as Amgen, which has made a success by bringing Epogen and Neupogen – the artificial versions of naturally occurring enzymes, to market during the past 20 years.

Amgen has earned $5 billion in sales of the two drugs since 2002, a full third of that being profit.

However, the technology on which those drugs are based came from outside the company. Drug companies justify high prices by citing a Tufts University calculation that it costs $800 million to develop a new drug and bring it to market.

Cancer Drug: Rising Price a Concern

2006-09-29T22:32:00.000-07:00

A Cancer Drug's Big Price Rise Is Cause for Concern
Source: NEW YORK TIMES, March 12, 2006
Newest Cancer Drug Unaffordable

On Feb. 3, Joyce Elkins filled a prescription for a two-week supply of nitrogen mustard, a decades-old cancer drug used to treat a rare form of lymphoma. The cost was $77.50.

On Feb. 17, Ms. Elkins, returned to her pharmacy for a refill. This time, following a huge increase in the wholesale price of the drug, the cost was $548.01.

The increase has stunned doctors, who say it starkly illustrates two trends in the pharmaceutical industry: the soaring price of cancer medicines and the tendency for those prices to have little relation to the cost of developing or making the drugs.

"Nitrogen mustard has been around forever," said Dr. Len Lichtenfeld, the deputy chief medical officer of the American Cancer Society. "There's nothing that I am aware of in the treatment environment that would explain an increase in the cost of the drug."

After years of defending high prices as necessary to cover the cost of research or production, industry executives increasingly point to the intrinsic value of their medicines as justification for prices.

In some drug categories, such as cholesterol-lowering treatments, many drugs compete, keeping prices relatively low. But when a medicine does not have a good substitute, its maker can charge almost any price.

In 2003, Abbott Laboratories raised the price of Norvir, an AIDS drug introduced in 1996, from $54 to $265 a month. AIDS groups protested, but Abbott refused to rescind the increase.

And once a company sets a price, government agencies, private insurers and patients have little choice but to pay it. The Food & Drug Administration does not regulate prices. The result has been soaring prices for some drug classes, notably cancer treatments.

In 1992, Bristol-Myers Squibb faced protests for its plans to charge $4,000 a year for Taxol, a breast cancer treatment. Now, most new cancer treatments are priced at $25,000 to $50,000 annually.

Last year, Genentech raised the price of Tarceva, a lung-cancer drug, by about 30 percent, to $32,000 for a year's treatment.

In an interview last month, Dr. Susan Desmond-Hellmann, the president of product development for Genentech, said that the company had raised Tarceva's price because the drug works better than Genentech had anticipated. Tarceva was a more powerful and more active agent than what we understood at the time of launch, and so more valuable, she said.